Work related mental stress is a devastating problem that negatively impacts staff productivity and contributes to people turning to drugs and alcohol in the hope of finding relief. That is unfortunate because the reality is that substance abuse intensifies stress, and stress is a known risk factor for the potential development of addiction. A number of brain imaging studies have shown that there are physiological reasons for this circular state. Ongoing stress alters brain activities, as does regular and chronic use of drugs. The net effect is that impulse controls, stress regulation, and compulsive drug seeking are enhanced, leading to people searching for relief. In other words, stress and drug and alcohol use partner to create greater vulnerability to addiction.i
There are some industries that are considered to have jobs that are more high stress than others. They include mining, engineering, aviation, and healthcare, to name the largest ones. Though all are high stress, there is admittedly something especially distressing about healthcare workers who abuse drugs and alcohol. They are responsible for the health of people who are completely dependent on their doctors, nurses, and other healthcare professionals to make critical decisions.
Healthcare workers are mere humans, just like miners and engineers and pilots, and the Australian Health Practitioner Regulation Agency (AHPRA) tribunal often deals with cases involving substance abuse. For example, in Nursing and Midwifery Board of Australia v Mundy  SAHPT 5, a nurse was convicted of drug trafficking offences involving meth, cannabis and diazepam. She admitted to being a meth user. Because the nurse was a repeat offender, the AHPRA imposed conditions that included a 3 month suspension, prohibition of the use of non-prescription medicines, and random urine testing.ii
“I Can Handle It”
A lot of effort has been put into trying to understand why doctors, nurses, psychiatrists, hospital aides, and other healthcare professionals and workers would abuse drugs and alcohol. The literature lists a number of reasons. There is obviously easy access to scheduled drugs. Healthcare staff work very long hours and deal with difficult, emotional cases every day, which contributes to mental stress.iii However, the problem is more complex than long work hours and easy drug access.
People have a difficult time understanding how trained medical professionals could become drug addicts or alcoholics. These are practitioners who are well aware of the dangers of substance abuse. Researchers have created a term that may describe the reason best – the intellectualisation of drug use. Educated healthcare professionals believe they can handle the drugs or alcohol because of, and not in spite of, understanding their impact on the body and mind. Doctors and nurses, in particular, tell themselves they can handle it and are above addiction. Clearly, they are not. It is difficult to find any specific numbers, but suffice it to say that based on the studies to date there is a strong indication that hundreds (and probably thousands) of Australian healthcare workers are abusing drugs and alcohol.
A Call for Random Drug Testing
There is a growing national call for random drug and alcohol testing of all healthcare professionals in hospitals and other facilities. As a minimum, random drug testing should be considered for any facility and in any industry where there is a known substance abuse problem.
Quality drug and alcohol testing equipment can be provided by CMM Technology (http://cmm.com.au/) which provides services across many industries, including healthcare. The right testing materials makes it easy to administer the program, thus promoting workplace safety and good decision-making.
1. Rajita Sinha, “Chronic Stress, Drug Use, and Vulnerability to Addiction,” Ann NY Acad Sci, (October 2008), 1141: 105-130, doi: 10.1196/annals.1441.030.
2. “Health Practitioner Tribunal Case Summaries N 4-11 April 2013,” Australian Health Practitioner Regulation Agency, accessed at http://www.ahpra.gov.au/Search.aspx?q=drug%20addiction.
3. Schattner P, Davidson S, Serry N. “Doctors’ health and wellbeing: taking up the challenge in Australia.” Med J Aust (2004); 181: 348-349.